Sadness, Depression, and Dysthymia: What is the difference?

With the ever-changing nature of the world, our lives, and our relationships, it is relatively common and even normal to experience down days here and there. Sometimes this is due to loneliness, disappointment, conflict, or perhaps a loss or breakup.  If you are currently trying to understand if the way you feel is part of life’s ups and downs or if there is something deeper you are dealing with, this blog is a great place to start.

The Difference Between Sadness and Depression

Sadness is a well-known and healthy emotion that comes up for us as a natural part of life. Sadness reveals itself when we encounter disappointment, feel hurt, or discover a challenging experience, and it is likely not something humans encounter just once. It is often also tied to a triggering event or series of events. Typically,  feelings of sadness fade over time as we learn to cope or find a way to adjust.

Depression, on the other hand, is more than a familiar feeling that fades. According to Psychology Today, Depression is an emotional state that significantly impacts our behavior, how we perceive situations, how we recognize our emotions to such a degree that it affects our quality of life. Unlike sadness, depression does not require a qualifying event to occur, and it can persist even in the absence of a triggering stimulus. Depression acts as a wet blanket that stays with us on a day-to-day basis in a sort of lingering way. It makes positive experiences less enjoyable, depletes our energy and motivation, and can even cause us to doubt feelings of love, connection, and belonging. Depression can display itself in various ways and may have different presentations and diagnosis under the American Psychiatric Association Diagnostic Criteria (DSM V). For this blog; we will be focusing on the criteria of Major Depressive Disorder and how it differs from Persistent Depressive Disorder (also known as Dysthymia)

Major Depressive Disorder

To meet the DSM V criteria for Major depressive Disorder,  five or more symptoms listed below must be present during the same two week period and show a marked difference in functioning during this time:

  •  Display of depressed mood all day, every day as noted in self-report or observation of others.  It may present as feeling sad, empty, hopeless, or appearing teary-eyed. 
  •  Notable lack of interest or significantly decreased pleasure in all or most daily activities nearly every day.
  • Significant unintentional weight loss or gain without dieting or intentional purpose(a change of more than 5% of body weight within a month) or decrease or increase in appetite nearly every day
  •  Insomnia or hyper insomnia almost every day
  • Psychomotor agitation nearly every day (this must be observable by others, not just self-report of feeling restless)

Feelings of fatigue or struggling to complete basic tasks almost every day.

  •  Feeling guilty or worthless almost every day
  •  Decreased ability to concentrate on tasks or make decisions almost every day (can be subjective account or observed by others)
  • Recurring thoughts of death, suicidal ideation without a specific plan or suicide attempt, or having a plan for suicide(not just fear of dying)

The presenting symptoms must also include a diminished ability in social settings, occupational settings, or other fundamental areas of functioning and not attributed to another medical condition or physiological effects of a substance or medication.


MDD and Dysthymia present similarly in their symptomology and include similar criteria such as:

  • feeling sad, empty, hopeless, or appearing teary-eyed. 
  • Feeling anger or frustration to even minor events
  • losing interest in normal daily activities such as sports, sex, or hobbies
  • sleeping too little or too much
  • responding to even small tasks with a lack of energy
  • change in appetite
  • weight loss or gain
  • feeling guilty or worthless
  • having trouble making decisions, thinking, concentrating, and memory recall

Although some of these symptoms mirror each other, it is essential to recognize the differences. Dysthymia is a chronic,  typically less severe version of depression that is more long-term. Those who experience PDD will often not meet the criteria for MDD because the symptoms are not nearly as intense.  To meet the requirements for Dysthymia, the patient must be experiencing symptoms consistently for two years, whereas patients with Major Depressive Disorder must display signs for two weeks.

Another primary consideration is the persistence of depression. Those with Major Depressive Disorder can return to a normal mood baseline outside of a depressive episode. Dysthymia, in contrast, is present all the time and those affected typically cannot recall a time where they were not depressed.


If the criteria for either or both of these disorders feel fitting to you, it is important to discuss potential options with your care providers for support. Cognitive Behavior Therapy and behavioral activation are standard techniques used to treat different types of depression in therapy; They can be effective when paired with potential medication options such as SSRIs, SNRIs, or TCAs.

Regardless of if you have MDD, PDD, or are just experiencing a difficult time and could use support; It is essential to acknowledge that you are never alone. Let Gateway to Solutions guide you through Processing your feelings, and get started with therapy today!

Leave a Comment

vulnerable thinking girltherapy dog in vest Call Us